Aspartate aminotransferase to platelet ratio index for fibrosis evaluation in chronic viral hepatitis

Chrysanthos, N.; Papatheodoridis, George V.; Savvas, Savvas; Kafiri, Georgia; Petraki, Kalliopi; Manesis, Emanuel K.; Archimandritis, Athanasios

doi:10.1097/00042737-200604000-00012

Cited by 48 publications

(58 citation statements)

References 31 publications

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“…APRI, AST/ALT, platelets, AST, albumin, total bilirubin and alkaline phosphatase which are well-known predictors of advanced liver diseases (9)(10)(11)(12)(13)(14)(15) (9). In this study, the cutoff values of APRI were set at 0.…”

Section: Discussionmentioning

confidence: 99%

“…8 T a b l e 2 . Co mp a r i s o n o f No n i n v a s i v e S e r u m Ma r k e r s a mo n g Di f f e r e n t S t a g e s o f L i v e r F i b r o s (12). Recently, the pathogenesis of liver fibrosis in CHB was suggested to be different from that of CHC (13) (20).…”

Section: Discussionmentioning

confidence: 99%

“…(9). APRI has been used in the evaluation of patients with alcoholic liver fibrosis, CHB, and CHC (9)(10)(11)(12)(13) T a b l e 1 . Cl i n i c a l Ch a r a c t e r i s t i c s o f Ch r o n i c He p a t i t i s P a t i e n t s i n T h i s S t u d (Fig.…”

Section: Hepatitis B Virus (Hbv) and Hepatitis C Virus (Hcv) The Majmentioning

confidence: 99%

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Retrospective Evaluation of Serum Markers APRI and AST/ALT for Assessing Liver Fibrosis and Cirrhosis in Chronic Hepatitis B and C Patients with Hepatocellular Carcinoma

et al. 2008

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Retrospective Evaluation of Serum Markers APRI and AST/ALT for Assessing Liver Fibrosis and Cirrhosis in Chronic Hepatitis B and C Patients with Hepatocellular Carcinoma

et al. 2008

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“…[48][49][50][51] Biopsy quality was considered acceptable in only 4 of the 22 studies. 51,53,57,63 According to the Quality Assessment of Diagnostic Accuracy Studies scale, the methodological quality of the included studies was very good. Thirteen studies met all 14 requirements of this scale; 6 studies met 13, and 2 studies met 12.…”

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

Diagnostic accuracy of the aspartate aminotransferase-to-platelet ratio index for the prediction of hepatitis C–related fibrosis: A systematic review

2007

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The development of noninvasive markers of liver fibrosis is a clinical and research priority. The aspartate aminotransferase-to-platelet ratio index (APRI) is a promising tool with limited expense and widespread availability. Our objective was to systematically review the performance of the APRI in hepatitis C virus (HCV)-infected patients. Random effects meta-analyses and areas under summary receiver operating characteristic curves (AUC) were examined to characterize APRI accuracy for significant fibrosis (stages 2-4) and cirrhosis. In 22 studies (n ‫؍‬ 4,266), the summary AUCs of the APRI for significant fibrosis and cirrhosis were 0.76 [95% confidence interval (CI), 0.74-0.79] and 0.82 (95%CI, 0.79-0.86), respectively. For significant fibrosis, an APRI threshold of 0.5 was 81% sensitive and 50% specific. At a 40% prevalence of significant fibrosis, this threshold had a negative predictive value (NPV) of 80%, but could reduce the necessity of liver biopsy by only 35%. For cirrhosis, a threshold of 1.0 was 76% sensitive and 71% specific. At a 15% cirrhosis prevalence, the NPV of this threshold was 91%. Higher APRI thresholds had suboptimal positive predictive values except in settings with a high prevalence of cirrhosis. APRI accuracy was not affected by the prevalence of advanced fibrosis, or study and biopsy quality. However, the accuracy for cirrhosis was greater in studies including human immunodeficiency virus (HIV)/HCV-co-infected patients. Conclusion: The major strength of the APRI is the exclusion of significant HCV-related fibrosis. Future studies of novel markers should demonstrate improved accuracy and cost-effectiveness compared with this economical and widely available index. (HEPATOLOGY 2007;46:912-921.)

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“…16,28,31 Another survey found some evidence of accompanying cardiovascular risks (metabolic syndrome) for live function test elevation to predict a severe fibrosis. 28,37,48,75,76 Therefore, usefulness of serum transaminase activities ratio was limited in predicting the severity of histological abnormality in NAFLD patients, 9,16,70,77,78 but not as diagnostic test of NAFLD, or in distinguishing NASH from NAFLD. 6,29,70 Table 2 presents results of some studies for diagnostic criteria based on plasma sample.…”

Section: Biochemical Testsmentioning

confidence: 99%

Nonalcoholic fatty liver disease: a challenge for pediatricians

Widhalm

Ghods

2010

Int J Obes

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Background: Nonalcoholic fatty liver disease (NAFLD) is the most common cause of pediatric liver disease. Its prevalence is related to the growing epidemic in childhood obesity during the past decades. At present, NAFLD and nonalcoholic steatohepatitis (NASH) are increasingly recognized worldwide. In spite of alarming trend in the epidemiology in pediatric field and growing risk of end stage liver disease, there is no significant advance in its diagnosis and treatment. Aim: To provide a detailed review for diagnosis and management of NAFLD and NASH. Methods: By using Pubmed to find review articles and relevant research. Results: The prevalence ranges from at least 3% in children overall to about 50% in obese children. The noninvasive biomarkers can be used to identify NAFLD/NASH patients. Diagnostic criteria based on biochemical and immunological indicators in the high-risk group of children could prevent about half of cases from receiving an invasive test. The pharmacological and surgical interventions have shown a growing role in pediatric NAFLD. Novel treatment modalities, such as probiotics, have hardly been studied. Conclusion: Early diagnosis by using noninvasive screening methods in high-risk groups is the most effective strategy against the NAFLD. The biology of early growth and development, including hepatic metabolism, may hold the key to pediatric NAFLD. Prevention of overweight children and childhood obesity is undoubtedly the best strategy for treating NAFLD.

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Aspartate aminotransferase to platelet ratio index for fibrosis evaluation in chronic viral hepatitis

Abstract: APRI is significantly associated with the extent of fibrosis, but it does not classify correctly 40-65% of patients with chronic hepatitis C or HBeAg-negative chronic hepatitis B, and thus it cannot replace liver biopsy.

Cited by 48 publications

References 31 publications

Retrospective Evaluation of Serum Markers APRI and AST/ALT for Assessing Liver Fibrosis and Cirrhosis in Chronic Hepatitis B and C Patients with Hepatocellular Carcinoma

Retrospective Evaluation of Serum Markers APRI and AST/ALT for Assessing Liver Fibrosis and Cirrhosis in Chronic Hepatitis B and C Patients with Hepatocellular Carcinoma

Diagnostic accuracy of the aspartate aminotransferase-to-platelet ratio index for the prediction of hepatitis C–related fibrosis: A systematic review

Nonalcoholic fatty liver disease: a challenge for pediatricians

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